Interview with Gary Taubes (part 8)

INTERVIEWER Marc Hellerstein thought that the obesity epidemic was caused by people being sedentary?

TAUBES He believed that the key is whether you’re sedentary compared to how you used to be. When I told him about the Pima and the Sioux Indians and this 1981 study of obesity in oil field workers, he had an excuse for everything. So the Pima and the Sioux Indians, they lived on reservations, so they could be obese because they were relatively sedentary, at least more sedentary than they used to be. And the oil field workers, well, theyâ€™re Mexican-American, so they have some kind of â€œthriftyâ€ gene going. You knowâ€¦this is what pathological science is: a field in which you can find a reason to explain away all negative evidence. In pathological science, it’s no longer possible to refute the hypothesis. Remember, science is about trying to test your hypothesis and refute it, but in a field like this, if you test it and come up with a counter-example, the counter-example is just explained away with whatever comes to mind. Negative evidence never means anything. So you have an obese person whoâ€™s sedentary, thatâ€™s proof of my hypothesis. If you have an obese person whoâ€™s very active — at least, compared to most people today — the Sioux indians, for instance, who were so poor they had to walk down to the river to get their drinking water; who had no televisions, no cars; they had to walk outside to evacuate their bowels — those people are obese because they used to be more active than they are now.

INTERVIEWER Iâ€™ve never heard that before: “They used to be more active.”

TAUBES But thatâ€™s the implication of Hellerstein’s knee-jerk reservation hypothesis. They may be poor, and they may be out working in the fields, so compared to us, theyâ€™re active, but compared to their former life, theyâ€™re sedentary. See what Iâ€™m saying?

INTERVIEWER Yeah, I understand the logic. Iâ€™ve just never heard it before.

TAUBES Well, the reason youâ€™ve never heard it before is because youâ€™ve never heard anyone have to explain why obesity was common in an impoverished Native American tribe in 1902 or in 1928. When confronted with that observation, they have to come up with an explanation so that they donâ€™t have to question their hypothesis. I happen to challenge someone who believes the conventional wisdom unconditionally, and thatâ€™s the response I get: â€œWell, theyâ€™re living on reservationsâ€.

INTERVIEWER Does he do research on weight, on obesity?

TAUBES Absolutely, he does.

INTERVIEWER That’s unfortunate.

TAUBES This is why the field is in the position itâ€™s in. These people believe so strongly in the calories in/calories out/gluttony/sloth combination that they no longer function as scientists. They canâ€™t imagine the existence of an alternative hypothesis. So everything they see, they have to find a way to interpret it so that it supports what they already believe to be true.

INTERVIEWER They donâ€™t see that theyâ€™re operating differentlyâ€¦

TAUBES â€¦than other scientists.

INTERVIEWER Do they see that theyâ€™re not making progress?

TAUBES No, because that gets blamed on the obese. If you believe that obesity is caused by sloth, then the reason fat people are fat is because they don’t have the moral fortitude to go run ten miles every day the way you do.

INTERVIEWER Well, people have been saying that for 50 or 60 years. So the fact that theyâ€™re saying the same thing now as they were saying 60 years is a sign, to me, that theyâ€™re not making progress.

TAUBES Yes, that’s a very good sign, but these people don’t realize they’re saying the same things and doing the same experiments and making the same mistakes that their predecessors made a century go because they don’t bother reading that literature. For reasons I still don’t really understand, these people see no reason to pay attention to the history of their field. Imagine if physicists saw no reason to pay attention to Einstein and Plank and Maxwell and Heisenberg? I mean, these guys all lived a century ago, why would anyone want to know about them or the experiments they did? But in physics, mathematics and even biology, the history is carried along with it. As the science progresses, it takes with it the successful ideas and the students learn about the history along with the science. In obesity research, World War II just cut all of that off. For whatever reason, several generations of researchers grew up with this belief that the history of the field doesnâ€™t matter. And so they don’t even know or care that they’re saying the same thing and doing the same experiments that their predecessors did 100 years ago. And then this latest generation is full of young molecular biologists, and they start the clock in 1994, when leptin was discovered. Theyâ€™re not aware that theyâ€™re not making progress, because they believe that nothing of value was done until 1994.

INTERVIEWER The birth of a new world. In your book, you seem to place weight on the fact that Atkins was disliked by people he went to school with. Did I read that wrong?

TAUBES I think that was part of it. I think the fundamental problem with Atkins is that his book emerged in 1972 , when the low-fat dogma was really beginning to be taken seriously, not just by the heart disease researchers, but by physicians and public health authorities. It was viewed as a great triumph of modern medicine. We finally understand what causes heart disease. Then Atkins goes out of his way to throw the high-fat nature of his diet out there: â€œYou can eat Lobster Newberg, double cheeseburgers, and porterhouse steaks” (like my New York Times Magazine cover). The AMA always had this philosophy that even if people wanted to lose weight, they should go to their doctor and discuss it with them. You shouldnâ€™t go on a diet without your physicianâ€™s guidance. So here Atkins was end-running all of that. Then he was saying â€œeat a high-fat diet. Itâ€™s harmlessâ€. He actually said â€œItâ€™s good for you.” If you read Atkins, he read a lot of the papers I read. His understanding wasnâ€™t tremendously sophisticated, but he didnâ€™t have the advantage I had, of coming along 40 years later. For the time, he was doing pretty damned good. He believed that triglycerides were the problem, not cholesterol. He believed that insulin was a problem. He was a working physician; he didnâ€™t have the time that I did to read all of the research, and to have the internet available to allow him to track down all of the references. But the establishment thought his diet was dangerous. And then Atkins made these claims that he had patients who consumed 5000 calories a day and still lost weight, so they also believed Atkins was a quack, a shyster trying to sell impossible dreams. And they thought this because they believed that calories in/calories out was all that mattered. They had this inherent belief that in order to lose weight, you have to restrict calories; Atkins said you didnâ€™t. So, to these establishment nutrition types, Atkins was saying that the laws of thermodynamics can be ignored. So they had reason to think that Atkins’s diet couldnâ€™t possibly work, on the one hand, and that it would kill you, on the other. So these â€œresponsible physicians,â€ as they perceived themselves to be, felt an obligation to suppress this threat to the public health. The fact that they knew Atkins personally, that some of them had worked with him and gone to medical school with him and didn’t particularly like him, made it all that much more . . .

INTERVIEWER Irresistible.

TAUBES Yes, irresistible. One of the things I mentioned in my lecture was something I didnâ€™t realize this when I wrote the book. Atkins proposed that one reason carbohydrates-restriction worked is that it stimulated the secretion of something that British researchers in the 1950s had called Fat Mobilizing Hormone. The joke is that you didnâ€™t need a Fat Mobilizing Hormone; the thing you have to do to mobilize fat is lower insulin levels and the way to do that is to remove the carbohydrates from the diet. That’s what mobilizes fat from the fat tissue. But Atkins was doing what a lot of diet book authors do, which was combing the literature for everything and maybe anything that might support his argument. He talked about insulin, but he also talked a lot about Fat Mobilizing Hormone, which was controversial at the time but not an outrageous idea. At the time Atkins wrote the book, this Fat Mobilizing Hormone had yet to be nailed down, and it never would be. The fundamental requirement to mobilize fat, as I said, is to lower insulin. So, the American Medical Association publishes this famous article dedicated, effectively, to establishing that Atkins has no credibility and one of the ways they do it is to discuss how Atkins was wrong about this idea of Fat Mobilizing Hormone. Then in the same paragraph they also say â€œin order to mobilize fat, you have to lower insulinâ€. Then they go back to talking about how Atkins jumped the gun on Fat Mobilizing Hormone . So they know that insulin controls fat accumulation, and they say actually acknowledge it in the article, but only in the context of it supporting the argument that Atkins has no credibility. They never mention that the way to lower insulin — and so, apparently, to mobilize fat from the fat tissue — is to eat less carbohydrates, which is exactly what Atkins was recommending. I was writing my response to Gina Kolata’s review when I first really noticed that sentence, and it jumped out at me. â€œHoly shit!” These people knew what regulates fat tissue, and they know what regulates insulin. They just donâ€™t care. Thatâ€™s how dedicated they were to trying to squash Atkins.

INTERVIEWER It didnâ€™t matter whether evidence supported them or that there was something there that they couldnâ€™t explain. It just mattered that he was wrong about something.

TAUBES All they wanted to do was establish that Atkins was not a credible source, and people shouldnâ€™t follow these bizarre practices of nutrition, or whatever they called it. One of the things Iâ€™m curious about is whether, from here on, the American Heart Association and other health authorities will continue to refer to low-carb diets, the Atkins diet, as these fad diets. Even though, if nothing else, as I point out in the book, these diets constituted the preferred medical treatment of obesity for 150 years, or 100 years, until the low-fat diet came along. It’s the low-fat diet that’s the fad.

INTERVIEWER Thatâ€™s an interesting point. What is the fad diet? Is it the absence of the Atkins Diet, or its presence? Which is temporary?

TAUBES The idea that you could somehow lose weight by removing fat and increasing carbohydrates is as ludicrous as the idea that you could do it by eating ice cream for any extended period of time. Iâ€™m sure thereâ€™s something about the ice cream diet that works in the short term. Iâ€™m not sure, but I wouldnâ€™t be surprised.

20 Replies to “Interview with Gary Taubes (part 8)”

“The idea that you could somehow lose weight by removing fat and increasing carbohydrates is as ludicrous as the idea that you could do it by eating ice cream for any extended period of time.”

Overreaching, to put it mildly. People lose weight that way all the time. For example, at places like Dr. McDougall’s clinic, which practices low fat/high carb in the extreme, with no limitations on intake, massive weight losses are common, not to mention reducing or eliminating insulin and blood pressure medications.

“Our patients’ average weight loss is 4 pounds (2 Kg) in 7 days; that’s half a pound a day while eating unlimited amounts of delicious foods, served buffet-style. Significant improvements in blood pressure, cholesterol, triglycerides, and blood sugar are seen. […] Most (over 90%) people are able to stop their medications for hypertension, type-2 diabetes, arthritis, indigestion, and constipation. Those who must stay on medications are often able to switch to simpler, safer, more effective, and less expensive ones.”

Since the medical and scientific communities seem hopeless regarding nutrition, why not try to sell your book to Oprah. I say this not only because she can make a book a bestseller, but especially because she has had an epic struggle with her weight all of her life. I would guess that it’s those of us who’ve struggled with food and have the most to gain from your insights, who are your biggest fans.

Since reading your book and everything else I can find related to it, I’ve come across information linking insulin/blood sugar with eating disorders, mood disorders, alcoholism and addiction, night eating syndrome and more. I’m not overweight but have struggled with food and various disorders all of my life and reading your book gave me the motivation to try something different. I’d been fat-phobic and ate little protein or fat for years and I can only wonder what havoc that wreaked on me.

Anyway, I’m a huge fan of the book and hope that it breaks through the mental fog of the mainstream nutrition field. I understand that you don’t want to spend time on a website but something simple just to alert people about new events/interviews would be great.

In no way is it a personal attack; I’m merely turning the tables regarding your repeated query about my reading Taubes’ book. You seem to be questioning my qualifications (when of course, the only thing that matters is whether one’s statements are true or plausible and whether they can be backed up). So, for the record, my background is in microbiology, biochemistry, and pharmacology, the last at the grad level. What’s yours?

I’ll also take your response to my question about reading in nutrition to be “no”.

Tom, you seem to be blind to the fact that every time I write something critical of Gary Taubes, you bring up me. Look at your first comment:”Which you would know.

If
you
READ
THE
BOOK
! ”

Anyone who reads my blog or my comments here can see that I’m a complete ignoramus who never reads anything.

In any case, I’m responding to words on this page, not somewhere else, and I’ve backed up my claims wherever I’ve made them.

So, Tom, do us all a favor, and unless you’ve got something substantive to say, that is something that isn’t about me or my reading habits or my qualifications to comment on Gary Taubes’ bad science and misleading statements (like the one above)…

I notice that Taubes himself makes a number of insinuations about other peoples’ motivations, e.g. “They just donâ€™t care. Thatâ€™s how dedicated they were to trying to squash Atkins. […] All they wanted to do was establish that Atkins was not a credible source, and people shouldnâ€™t follow these bizarre practices of nutrition, or whatever they called it.”

I imagine differences of opinion regarding what constitutes the “proper” approach to weight control could be resolved if more experts understood the importance of “Biochemical Individuality.” That’s the title of a book by Roger J. Williams that was published more than 30 years ago. Mainstream science is only now beginning to appreciate the range of variation in human metabolic makeup as manefested in individualized responses to food intake.

Some people are really not all that sensitive to carbs. Others must strictly limit their intake to keep from gaining weight. There’s some excellent discussion of this on pages 85-86 of “Nutrition Against Disease,” also authored by Dr. Williams. For example: “Kuo and his coworkers found that the liver tissue of individuals with high blood fat levels took up fructose five times as rapidly as individuals whose blood-fat levels were lower. Fat tissue from individuals with high blood fat levels also took up fructose seven to eight times more rapidly than the fat tissues of individuals with low blood fat levels. This shows how biochemical individuality comes into the problem and gives us a lead as to how some individuals may be adversely affected by the fructose content of sucrose.”
The notes at the back of the book contain further comment: “In their study of eight â€œhyperlipidemicâ€ patients, Kuo and colleagues found that dietary sugar (sucrose) administered to patients causes blood fats to increase, while starch tends to lower them. They found that individuals who had low blood fat levels were relatively resistant to the effects of sugar, and that 85 to 90 percent of the total calorie intake in sugar was required to produce hyperglyceridemia.”

Notice the difference between metabolic response to starches and sugar. For some, just reducing sugar intake while consuming all the unrefined carbs they want will result in weight loss. So Dr. McDougall’s approach does work for some but not for others.

I suggest you guys read a December 10, 2007 article by Carmen Drahl published in CE&N subtitled “The maturing field of metabolomics is taking steps toward guiding personalized nutrition.”

Actually, Varangy, I don’t think it’s outrageous at all. I experienced a similar rapid weight loss years ago, and it was on a very low fat diet. At the time I was following a plan very similar to the low-fat diet outlined in “Eat More, Weigh Less” by Dr. Dean Ornish. 4 pounds a week for an extended period of time seems unlikely, but 4 or 5 pounds during the first week of a program is not unusual. Of course, much of that weight might be from water loss and from your bowels and not really body fat loss.

Whatever the diet, a loss of 4lbs of fat equates to a ‘loss’ of approx 14000 calories. Much of initial large scale loss has to be more than just fat loss(which is the only thing that people actually want to lose) Losing even a pound of fat (3500 cal) over the long term would seem a pretty demanding target.

Varangy, It’s not far-fetched at all. I lost 50 lbs over 5 months following McDougall/Esselstyn’s plans, with much of the loss coming in the first 3 months. I’ve kept it off for over a year and a half and have never counted a calorie. If you take out extremely calorie dense foods (oils, meats, dairy) and substitute them with bulky less calorie dense foods, you will feel full on far fewer calories than ever before. If you doubt it so much, why don’t you just try it for a month and see? Don’t worry, eating lots of veggies and whole foods won’t hurt you.

I find .33 to .5 lbs of fat/day extremely hard to believe. I suspect a not insignificant portion was initial water weight.

Regarding my diet, I do eat so-called ‘whole foods’ as I have recently started eating hyperlipid* (majority of calories from fat, moderate amount from protein, little from carbs) and have had fantastic results. My average weight loss per day was about .12 lbs per day. My sleep has dramatically improved as well.

Well, after 2 years on the Esselstyn diet, not counting calories at all, and eating as much as I want, I’m still 50 pounds lighter than I was when I started, my exercise endurance is better than it was 20 years ago, and I’m off all medecines. Lipid panel for those who believe in these numbers are well below Esselstyn’s target of sub 159 TC. I have no idea if Taube’s and the low carb crowd are on to anything, but I see no reason to question whether Esselstyn’s diet works or not when it’s been so easy to maintain results. Really, if you doubt that this kind of weight loss is possible, just try it for a month and see what happens.